2019 Phoenix Patient Conference: Large Vessel Vasculitis
Kenneth J. Warrington, MD. Chair, Division of Rheumatology
Mayo Clinic, Rochester, MN
| Introduction to today’s topic: large vessel vasculitis. | 00:28 |
| Concepts common to all forms of vasculitis, including what is inflammation. | 00:40 |
| Signs of inflammation and the role of white blood cells. | 01:48 |
| What is a blood vessel and how is it affected by inflammation? | 02:26 |
| One of the most feared consequences in giant cell arteritis: loss of vision. | 03:18 |
| Description of different blood vessels and their association with organs in the body. | 04:12 |
| Vasculitis that affects the large arteries: GCA and Takayasu’s arteritis and how they affect the aorta, brain, eyes, and arms. | 04:50 |
| The genetic component of vasculitis. | 06:19 |
| Where people are from: increased risk in Northern Europe/Northern European heritage. | 07:18 |
| Environmental factors: viruses (shingles), bacteria, other infections and role of smoking. | 08:00 |
| Facts about GCA and who’s affected, along with the classic symptoms. | 09:48 |
| Symptom overlap of polymyalgia rheumatica and GCA. | 12:56 |
| Facts about Takayasu arteritis: who’s affected, symptoms. | 13:57 |
| Diagnosing and monitoring large vessel vasculitis: markers of inflammation and testing. | 15:47 |
| View of temporal artery ultrasound of normal and abnormal blood vessel. | 17:19 |
| Temporal artery biopsy and vascular imaging techniques with scanning (CT, MRI). | 18:54 |
| MRA scan and angiogram images, along with MRI scan looking at the normal/abnormal aorta. | 21:20 |
| What is a positron emission tomography (PET scan) and why is it needed? | 24:19 |
| History lessons: first patient to have a biopsy for GCA, discovery of cortisone in the 1940s to prevent blindness in GCA. | 26:27 |
| Phases of treatment: induce remission, remission maintenance, relapses (flares). | 27:57 |
| Common principles of treatment: healthy diet and exercise, and infection risk. | 29:03 |
| The good side versus the not-so-good side of glucocorticoids. | 30:43 |
| Risks and advantages of low dose prednisone and tocilizumab. | 32:15 |
| Treatment of Takayasu arteritis: glucocorticoids, immune suppressants, and biologics. | 36:02 |
| What is an aortic aneurysm? | 36:52 |
| Strategies to reduce disease- and treatment-related damage. | 37:39 |
| Questions from audience. | 38:32 |
